Summary
Overview
Work History
Education
Skills
Accomplishments
Certification
Timeline
Generic

CHARMAINE S. WILSON

Sunrise,USA

Summary

Highly perceptive and resourceful Business Analyst/UAT Lead with over 20 years of experience in project/data management, technical support, program implementation, and project maintenance. Skilled in supporting business initiatives through data analysis, performance tracking, ad hoc analytics, and identifying implementation barriers. Utilizes analytical, communication, and organizational skills to conduct root cause analysis and recommend solutions for corrective actions. Possesses extensive knowledge of managed healthcare operations practices and policies, including benefits, claims adjudication, training, audits, Medicare, Medicaid, value-based programs, and coordination of benefits. A methodical producer with a proven aptitude for identifying, evaluating, and solving business requirements to optimize company efficiency.

Overview

2026
2026
years of professional experience
1
1
Certification

Work History

General Manager of Food Service

Taste of the Islands
2021 - Current
  • Increased customer satisfaction by implementing effective staff training and performance management programs.
  • Optimized scheduling practices for efficient staffing levels during peak hours, reducing labor costs without sacrificing service quality.
  • Boosted employee morale with regular team-building activities, improving communication and collaboration.
  • Reduced food waste through better inventory management and portion control, leading to increased profitability.
  • Oversaw training of more than 15 team members.

Sr Business Process Analyst / UAT Lead Analyst

Optum Healthcare (Contract to Hire)
01.2018 - 01.2023
  • Performed comprehensive User Acceptance Testing (UAT) on new functionalities
  • Managed multiple large scale complex projects by priorities and deadlines
  • Cooperated with Business Stakeholders, PMs, and IT on project implementations
  • Lead cross 10 functional teams in the implementation of business system enhancements
  • Attended and facilitated client meetings to ensure business needs are met
  • Collaborated with End Users, IT and PMs to ensure requirements are within standards
  • Created/maintained UAT test plans/test scenarios to support complex operational changes
  • Monitored the progress of projects within the Application Lifecycle Management (ALM)
  • Worked closely with over 20 SMEs from the downstream areas with the execution of test scripts
  • Validated hundreds of member and provider information in system test environments
  • Identified and prioritized defects and managed resolution
  • Prepared test summary documents at the end of testing providing quality metrics
  • Presented lessons learnt to stakeholders with “next steps” to have improvement implemented

Quality Analyst

Sheridan HealthCorp/Envision Physician Services (Contract to Hire)
01.2016 - 01.2018
  • Performed UAT testing on user stories in ED, Anesthesia and Radiology in Inspired Quality
  • Reviewed and updated Neonatal business requirements for survey vitals
  • Created formulas and scoring conversion for physician office-based site visit tool
  • Performed detailed research in PremiEHR for neonatal services
  • Performed daily monitoring and updates of the anesthesia OPPE and ABG dashboards
  • Performed UAT testing on physician McKesson Billing Integration in Inspired Quality
  • Identified and implemented process improvements for quality abstractors
  • Formatted a group location master copy for AS400 and SMART billing systems
  • Performed data review in AS400 production
  • Assisted with updating ED data backlog in Inspired Quality
  • Collaborated with IQ product managers and software development teams on various projects
  • Knowledgeable in Provider Bonus Program and CMS reporting methodology
  • Performed monthly ED PQRS audits in billing systems SMART, AS400 and GE

Senior Claims Business Analyst

Emblemhealth
01.2008 - 01.2015
  • Reviewed and tested individual projects while meeting business requirements
  • Identified and communicated root cause analysis to team with test results that impacted projects
  • Assessed business requirements, developing appropriate system requirements and manual procedures
  • Created task plans, comprehensive test cases and executed user acceptance testing (UAT) throughout implementation
  • Managed requirements, tracked the progress, documented updates, logged issues and resolutions on the project and company's SharePoint
  • Evaluated procedural changes during implementation to ensure changes met business requirements and project objectives
  • Operated closely with IT system analysts and other departments throughout design and follow through with problem resolution
  • Provided written progress reports regarding status of projects and deliverables
  • Assumed leadership role on various projects
  • Trained 40 peers and other departments on system changes
  • Served as a subject matter expert for the hospital UAT team
  • Collaborated with business users and stakeholders to maintain relationships
  • Performed detailed regression and post implementation testing to validate positive results and ensured no negative impact occurred
  • Supported programming implementation in multiple systems, including Mainframe, EMC, OCR, Internet applications, Network Access, SeeBeyond, and Grouper
  • Participated in phases of the Software Development Life Cycle (SDLC)

Quality Assurance Analyst

EmblemHealth
2006 - 2008
  • •Conducted facility audits to ensure accurate application of policy and procedural guidelines
  • •Analyzed quality results and provided recommendations for operational improvements to claims management and training
  • •Performed complex claims analysis and audit activities, identifying trends, and determining root-causes of processing inaccuracies
  • •Prepared training materials and assisted content manager with updates of policies and procedures on centrally managed online repository
  • •Oversaw in-depth training of policies and procedures, facility claims, and adjudication t new claims for examiners and upper management
  • •Collaborated with senior management to resolve processing issues
  • •Directed departmental meetings and training presentations

Education

Some College (No Degree) - Nursing

Broward College
Davie

Skills

  • Proficient in Microsoft Office
  • Experience with AS400 applications
  • Proficient in CATS Tool
  • Inspired quality assurance
  • Mainframe operations
  • QCARE system proficiency
  • CSP Facets platform
  • OHBS Facets platform
  • ICUE proficiency
  • Proficient in agile practices
  • Network connectivity management
  • Application lifecycle management

Accomplishments

  • Resolved product issue through consumer testing.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.
  • Achieved expected results by completing multiple projects with accuracy and efficiency in a timely manner.
  • Documented and resolved system issues which led to troubleshooting technical issues.
  • Found solutions to get a project back on track despite unexpected delays.
  • Identified ineffectiveness and implemented solutions to streamline workflow.

Certification

Six Sigma Yellow Belt, UAT Certification

Timeline

Sr Business Process Analyst / UAT Lead Analyst

Optum Healthcare (Contract to Hire)
01.2018 - 01.2023

Quality Analyst

Sheridan HealthCorp/Envision Physician Services (Contract to Hire)
01.2016 - 01.2018

Senior Claims Business Analyst

Emblemhealth
01.2008 - 01.2015

General Manager of Food Service

Taste of the Islands
2021 - Current

Quality Assurance Analyst

EmblemHealth
2006 - 2008

Some College (No Degree) - Nursing

Broward College

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